Application / LP Business Garant

Consignor

Company name

Legal address, tel./fax, E-mail

Director (surname, name, patronymic)

Information about the freight

Freight name

Code according to UCCFEA

Freight nomenclature

Freight amount per unit

Total freight amount

For alcohol beverages:

Volume of 1 bottle

Alcohol content

For automobiles:

Engine displacement (cubic capacity)

Year of production

Invoice value per unit

Total invoice value of all goods taking into account transport charges (specify the currency)

Calculation of the amount of the customs debt

TOTAL customs debt

Selected transit route

Point of departure

Point of entry in Ukraine

Point of destination

Point of exit from Ukraine

Consignee

Company name

Legal address, tel./fax, E-mail

Director (surname, name, patronymic)

EDRPOU

Taxpayer's code

External economic agreement

Invoice

The person who has concluded the Agreement for Issuance of Financial Guarantees

Full company name

Legal address, tel./fax, E-mail

Director (surname, name, patronymic)

Forwarding agency

Company name

Legal address, tel./fax, E-mail

Director (surname, name, patronymic)

Railway transportation code

Information about the carrier and means of transport

Carrier name

Legal address, tel./fax, E-mail

Director (surname, name, patronymic)

№ wagon / car

№ container

The person who has completed the application

Surname, name, patronymic

Contact tel./fax

Additional information